Provider Demographics
NPI:1053925354
Name:BLANKENSHIP, COURTNEY LAWSON (AUD)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:LAWSON
Last Name:BLANKENSHIP
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6316 OLD OAK RIDGE RD STE A
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-9940
Mailing Address - Country:US
Mailing Address - Phone:336-617-3025
Mailing Address - Fax:
Practice Address - Street 1:6316 OLD OAK RIDGE RD STE A
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-9940
Practice Address - Country:US
Practice Address - Phone:336-617-3025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAUD.0001188231H00000X
NC30002441231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist